A systematic review and meta-analysis of 19 randomized controlled trials, encompassing 6,807 patients undergoing cardiovascular surgery, investigated the effect of tranexamic acid (TXA) administration on renal outcomes.

The primary finding suggested that TXA did not influence the incidence of postoperative acute kidney injury (PO-AKI), with comparable rates between the TXA group (4.2%) and the control group (4.3%).

Furthermore, analysis of secondary outcomes supported this conclusion, showing that PO-serum creatinine (PO-SCr) and PO-blood urea nitrogen (PO-BUN) levels were also similar between the groups.

Importantly, TXA also did not influence the 30-day postoperative mortality rate. However, a beneficial effect was observed: TXA shortened the length of stay in both the intensive care unit (ICU) and the hospital.

This study suggests that TXA administration in cardiovascular surgery is safe concerning renal outcomes and may offer the advantage of reduced ICU and hospital stays. Given the study’s limitations, the authors recommend further large-scale, randomized trials to solidify these findings.

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